A client at 37 weeks' gestation has been advised that she is positive for group B streptococcus (GBS). Which of the following comments by the nurse is appropriate at this time?
The doctor will prescribe intravenous antibiotics for you.
A visiting nurse will administer them to you in your home.
You are at very high risk for an intrauterine infection.
It is important for you to check your temperature every day.
The bacteria are living in your vagina.
The Correct Answer is C
Choice A rationale
While intravenous antibiotics are given during labor to prevent GBS transmission to the baby, it is not administered at home but in the hospital when labor begins.
Choice B rationale
GBS does not significantly increase the risk of intrauterine infection that requires daily temperature checks; it primarily poses a risk of neonatal infection during delivery.
Choice C rationale
GBS bacteria reside in the vagina and can be transmitted to the baby during delivery. Administering antibiotics during labor helps protect the baby from serious GBS-related illnesses.
Choice D rationale
GBS does not cause scarlet fever or the symptoms described; those are caused by different bacteria, namely Streptococcus pyogenes. .
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Correct Answer is D
Explanation
Choice A rationale
Placental abruption is characterized by abdominal pain, vaginal bleeding, and uterine tenderness. It does not cause dyspnea, hypotension, frothy sputum, or loss of consciousness.
Choice B rationale
Uterine rupture typically presents with severe abdominal pain, abnormal fetal heart rate patterns, and vaginal bleeding. Shock can occur, but not frothy sputum or sudden dyspnea.
Choice C rationale
Uterine inversion leads to pain, hemorrhage, and shock. It does not present with frothy sputum or sudden dyspnea.
Choice D rationale
Anaphylactoid syndrome (amniotic fluid embolism) results from amniotic fluid entering maternal circulation, causing an anaphylactic reaction. Symptoms include sudden dyspnea, hypotension, frothy sputum, and loss of consciousness, matching the described scenario. .
Correct Answer is D
Explanation
Choice A rationale
Checking the blood sugar of a gestational diabetic is essential but not immediately life-threatening. Blood sugar levels should be monitored regularly throughout pregnancy for
diabetics to prevent complications. However, this does not represent an urgent priority when compared to the other options, which involve more immediate risks to life and health.
Choice B rationale
Assessing vaginal blood loss in a client recovering from a spontaneous abortion is crucial to monitor for hemorrhage or infection. Heavy bleeding could signal a serious complication
needing immediate intervention, though it is not the most immediate priority over monitoring fetal heart rate during active labor.
Choice C rationale
Monitoring the patellar reflexes of a client with pre-eclampsia without severe features can help in detecting early signs of progressing pre-eclampsia. While important, it is generally
not as critical as ensuring immediate fetal wellbeing, especially if reflexes do not present signs of worsening.
Choice D rationale
Checking the fetal heart rate in a client whose membranes have just ruptured is paramount. Rupture of membranes could lead to immediate complications such as umbilical cord
prolapse, leading to rapid fetal distress. Therefore, verifying fetal heart rate ensures that the fetus is not in immediate danger.